middle aged man sleeping in bed

6 Sleep Problems That Can Happen As You Age (and What to Do About Them)

by
/ January 18, 2022

Aging can bring many positives—including wisdom and an ability to take the long view on challenging situations. But when it comes to sleep, getting older can bring up issues we didn't have in our younger years. 

A lack of sleep or poor sleep quality can affect a range of health indicators for people over 60, according to Edward S. Goldberg, MD, founder of a concierge medical practice in New York City. 

“Many things change in terms of metabolism and hormones as we age,” says Goldberg. “So a lack of sleep can lower testosterone, raise blood pressure, and increase your risk of depression.”

Chronic sleep disturbance has also been linked to obesity, heart disease, and other potentially serious medical conditions. A UC Berkeley study even found that older people’s unmet sleep needs can increase their risk of memory loss

In fact, psychology professor Matthew Walker, PhD, one of the study’s authors, said, “nearly every disease killing us in later life has a causal link to lack of sleep.”

The good news is, there are steps you can take to sleep better and overcome the various sleep problems you might experience as you get older. Here are six of the most common sleep-disrupting issues that can happen as you age along with suggestions for dealing with them. 

Insomnia

According to the American Sleep Association, 30% of adults in the U.S. report short-term insomnia, and 10% report chronic insomnia. 

Rebecca Park, RN in New York City and founder of the blog RemediesForMe.com, says insomnia is more common in middle-aged and older adults—and women are more likely to develop it than men. 

Acute, or short-term, insomnia is defined as trouble falling or staying asleep at least three nights a week for at least two consecutive weeks. Chronic insomnia means it lasts longer than three months. 

Insomnia is more common in middle-aged and older adults—and women are more likely to develop it than men. 

Park defines these common signs of insomnia:

  • Difficulty falling asleep
  • Struggling to stay asleep and waking up frequently throughout the night
  • Feeling tired after waking up in the morning
  • Feeling fatigued and irritable during the day
  • Finding it difficult to concentrate due to fatigue

How to treat insomnia

Making lifestyle and dietary changes is the key to addressing your insomnia. Health experts offer these insomnia cures you can try for a better night's sleep:

  • Only go to sleep when you're tired.
  • Avoid sugar before bed.
  • Exercise early in the day.
  • Refrain from coffee and alcohol at night.
  • Ban your phone from your bed.
  • Limit what you do in bed to only sleep and sex.
  • Use sleep supplements cautiously.

Sleep apnea

If you wake up feeling exhausted even though you think you had a full night’s sleep, you may have sleep apnea. This sleep disorder that becomes more common as you age causes you to stop breathing while you're asleep, potentially many times a night. 

During these brief periods, called “apneas,” the muscles in your tongue and the back of your throat relax, causing your airway to narrow or become blocked when you breathe in. Sleep apnea is a serious condition as it can increase your risk for other serious conditions such as heart disease, diabetes, high blood pressure, and stroke.

Kent Smith, DDS, board-certified dental sleep medicine specialist and president of the American Sleep and Breathing Academy, says although the signs of sleep apnea vary, these are the most common ones:

  • Loud or persistent snoring
  • Lack of focus/inability to concentrate due to fatigue
  • Silent pauses in breathing while asleep
  • Nighttime gasping, coughing, or choking
  • Morning headaches
  • Difficulty staying asleep
  • Irritability, depression, or mood swings
  • Dry mouth or sore throat upon awakening
  • Frequent need to urinate during the night
  • Dozing off while driving or doing other daily activities
  • Insomnia of unknown origin
  • Night sweats

How to treat sleep apnea

Be sure to see your healthcare provider if you suspect you have sleep apnea. 

If your doctor determines you have sleep apnea, you'll most likely be prescribed an apparatus called a CPAP (continuous positive airway pressure) machine. CPAPs work by sending a constant flow of air into your throat which causes your airway to stay open while you sleep.

You may also find relief by changing your sleep position. If you're a back sleeper—the position most prone to aggravating sleep apnea—try sleeping on your side. Side sleeping helps stabilize the airways and reduce the chance they'll collapse or restrict air.

Restless Legs Syndrome

Restless Legs Syndrome (RLS), also known as Willis-Ekbom Disease (or colloquially as jumping legs or irritable leg syndrome) causes unpleasant or uncomfortable sensations in the legs often resulting in a strong urge to move them, creating "restless legs." 

People with RLS describe the feelings as tingly, crawling, and even burning.

RLS usually occurs at bedtime, though it can also happen while you're sedentary during the day. An estimated 7%-10% of the U.S. population suffers from RLS symptoms. 

An estimated 7%-10% of the U.S. population suffers from RLS symptoms. 

It's more common in women and can begin at any age, although it worsens as you get older. While there's no cure, non-drug therapies are an option in most cases. Most people with RLS symptoms ignore them, but the lack of diagnosis and treatment can reduce your quality of life.

How to treat Restless Legs Syndrome

Although only a medical professional can diagnose RLS, once you know you have it, there are steps you can take to relieve the symptoms and get your sleep back on track. Here are five quick tips to help mitigate unpleasant RLS symptoms:

  • Consider iron supplements: Research from Johns Hopkins Medicine shows iron deficiency is the single most common cause of Restless Legs Syndrome in patients, even when their blood contains normal levels of iron.
  • Exercise more: Researchers suggest exercise could be a relatively quick remedy for RLS symptoms: Participants in a trial study published in the Journal of the American Board of Family Medicine saw improvements after three weekly sessions of aerobic and lower-body resistance training for 12 weeks.
  • Practice mindfulness: A 2015 study in the journal Mindfulness concluded that a six-week program of mindfulness-based stress reduction improved symptom severity, sleep quality, RLS-specific quality of life, and overall mental health. 
  • Massage your legs: RLS can affect many of the muscles in your legs. But a 2007 study in the Journal of Bodywork and Movement Therapies found that focused lower leg rubs twice a week eased symptoms such as tingling sensations associated with restless legs, urges to move, and sleeplessness. This doesn't necessarily mean you have to shell out for a professional massage—even some light touches, circulation work, or a foam roller could help.
  • Take a hot bath: As part of a pre-bedtime ritual including stretches and leg rubs, consider loosening up with a hot bath. This can help ease muscle pain and release tension for those with restless legs. In addition, the high temperature can help to distract from the irritating tingling sensation that otherwise plagues RLS and give your mind some relief. Just remember not to make it too warm because too-high temps can make it harder for you to fall asleep.

Nighttime urination

An estimated 50 million people in the United States wake up two or more times a night to empty their bladders, a condition known as nocturia. Although the majority of people with nocturia are over 60, it's estimated to affect as many as one in 10 individuals aged 45 or younger

People with severe nocturia may get up as many as five or six times during the night.

Nocturia can wreak serious havoc on your sleep—and your overall wellbeing. A study of 1,214 women demonstrated that nocturia had a significant impact on quality of life in patients who made at least two trips to the bathroom at night. Increased sick leave and lower work productivity have also been reported by people with nocturia.

As many as two-thirds of adults ages 55 to 84 experience nocturia at least a few nights per week.

Among older adults, nocturia increases the chance of falls. Studies have shown that people who make at least two or more trips to the bathroom at night have a greater than twofold increase in the risk of fractures and fall-related fractures.

Nocturia can be caused by a variety of factors, including:

  • Urinary tract infection: A urinary tract infection (UTI) can trigger the need to urinate more during the day and as well as at night. You may experience urgency, pain with urination, and/or a fever.
  • Enlarged prostate: An enlarged prostate is common in older men and can make emptying the bladder difficult. Research presented at the 2017 American Urological Association meeting suggested a kind of chicken-and-egg relationship between benign prostatic hyperplasia (BPH), the term for enlarged prostate, and sleep. The researchers concluded that poor sleep can exacerbate BPH, and BPH frequently leads to disrupted sleep with nighttime visits to the bathroom.
  • Excessive fluid intake: Nocturia can be the result of drinking too many fluids, especially caffeine or alcohol, in the evening hours.
  • Menopause: The hormonal changes of menopause can contribute to nocturia as women age. 
  • Age: The prevalence of nocturia increases with aging. As many as two-thirds of adults ages 55 to 84 experience nocturia at least a few nights per week. As you get older, bladder function weakens and it becomes harder to hold in urine.
  • Weight: Very heavy people have an increased risk for nocturia, more so among women than among men. In men, higher weight is associated with increased prostate size, while in women, higher weight is linked to urinary incontinence. 

How to treat nighttime urination

If you suspect there's a medical reason for your nocturia—BPH or a UTI, for example—it's best to speak with your healthcare provider. But here are four things you can do to at least minimize nocturia: 

  • Avoid caffeine after lunchtime.
  • Limit alcohol at night.
  • Empty your bladder before bed.
  • Track your habits. Keep a diary for three to seven days, noting your nighttime bathroom trips, daytime fluid intake (type and amount), daytime bathroom trips, any bladder leakage, medications you take, and what time of day you take them. Then share the results with your healthcare provider, who can help identify patterns and, if necessary, suggest treatments.

Pain

Older adults often deal with a variety of aches and pains, any one of which can make it hard to get a good night's sleep. The good news: A new mattress can help ease some of the pain elderly people experience at night, says Tom Tozer, chiropractor at Imperium Chiropractic in Eau Claire, Wisc.

How to treat pain

Here are some tips to help you find the right mattress based on your particular pain and make sleeping more comfortable at night:

  • Arthritis: Tozer recommends an adjustable bed base for those with arthritis because it allows you to elevate certain areas, like the head and legs, which can help you get better rest. While adjustable beds don't necessarily support good posture, they do help make older people feel more comfortable, he adds. If an adjustable bed isn't in your budget, Tozer suggests using a mattress topper made with memory foam or latex to help reduce pressure in the shoulder and hip joints.
  • Fibromyalgia: This inflammatory condition causes scattered pain throughout your body. Although fibromyalgia can affect anyone at any age, it's most common in middle-aged and older adults. A mattress that conforms to your body and helps to relieve pressure points, such as a memory foam mattress or latex mattress, may make it easier for you to get a good night's rest if you have fibromyalgia. Doctors usually recommend firmer mattresses, which offer better support for your spine. Very soft mattresses can aggravate pain by getting you into bad sleep positions.
  • Back pain: Tozer says the best mattress for back pain is one that promotes good posture, according to your sleep position. Whether you're a side or back sleeper (he doesn't recommend stomach sleeping), you want to have your head aligned with your shoulders and your shoulders stacked over your hips. So if you sleep on your back, for instance, you might want to find a medium-firm mattress that supports the natural curves of your spine. If you're a side sleeper, going with a mattress on the softer side might help prevent adding pressure to your hips and shoulders. Tozer also recommends using a pillow between your knees to keep your hips and pelvis in line, which can take a little stress off your lower back.
  • Hip pain: Tozer recommends a medium-firm hybrid mattress made with memory foam since it'll support and cushion your joints. A latex mattress is another good option. Tozer also suggests selecting a mattress foundation with the appropriate height. "Consider their ability to enter and exit the bed," he says. "A mattress with a 14-inch box spring might be good because it makes it easier for [someone with hip pain] to stand up and get in and out of bed.” Lastly, avoid sleeping on your side because this can add more pressure and leave you with "dead arm," a tingling, numbing sensation that happens when you shift your weight to your arm as you sleep.
  • Neck and shoulder pain: Tozer says poor posture is the most common cause of neck and shoulder pain. "Sleeping on an unsupportive mattress at night can exacerbate this pain," he says. So he recommends choosing a mattress that promotes good posture when side or back sleeping. To keep your spine in neutral alignment while you sleep, choose a medium-firm mattress. Tozer also advises using a pillow of the appropriate thickness to ease neck pain. Likewise, a pillow that's thick enough to keep your head in line with your shoulders and hips can help back sleepers.

REM sleep behavior disorder

We don’t normally move during rapid eye movement (REM) sleep, a normal stage of sleep that occurs many times throughout the night, accounting for about 20% of our total sleep time. It’s the sleep stage in which we dream. 

In the case of REM sleep behavior disorder (RBD), the Mayo Clinic explains that you physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep. It’s sometimes called dream-enacting behavior, and it can worsen over time. 

One of the biggest risk factors for REM sleep behavior disorder is being male and over 50. However, more women, even those under 50, are being diagnosed with it these days. It can be associated with narcolepsy, brain tumors, or antidepressant use. 

Signs you may have RBD include:

  • Repeated times of arousal during sleep where you talk, make noises, or perform complex motor behaviors, such as punching, kicking, or running movements that often relate to the content of your dreams.
  • You recall dreams associated with these movements or sounds.
  • You're alert and not confused or disoriented if you're awakened during these episodes.
  • A sleep study (polysomnogram) shows you have increased muscle activity during REM sleep.
  • Your sleep disturbance isn't caused by another sleep disturbance, a mental health disorder, medication, or substance abuse.

How to treat REM sleep behavior disorder

The Mayo Clinic says RBD can be the first sign of developing a neurodegenerative disease, such as Parkinson's disease, multiple system atrophy, or dementia. 

This is why it's important to follow up with your doctor if you develop RBD. To diagnose RBD, your doctor will review your medical history and symptoms. Your evaluation may include a physical and neurological exam, talking with your sleep partner, and conducting an overnight study in a sleep lab.

Treatments include medication and making changes to your sleep environment to keep you safe.

For more information on sleep problems and how to treat them at any age, check out our guide to sleep disorders.

you may also like